CAJ | 학술논문

目的：探讨高血压病合并焦虑、抑郁患者的临床特点及其与心率变异性的关系。方法收集我院心血管内科病房和门诊收治的高血压病患者200例,根据是否合并有焦虑和抑郁,将所有患者分为焦虑抑郁组和非焦虑抑郁组,再根据是否抗焦虑抑郁治疗,将焦虑抑郁组患者分为试验组和对照组,对所有患者24 h动态血压和心率变异性进行分析。结果200例高血压病患者中存在焦虑70例(35.0%),抑郁65例(32.5%),焦虑抑郁组的焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分、24 h平均血压、白昼平均血压和夜间平均血压明显高于非焦虑抑郁组(P<0.05),而 NN间期标准差(SDNN)、NN间期平均值的标准差(SDANN)、相邻 NN间期差值的均方根(RMSSD)明显低于非焦虑抑郁组(P<0.05)。多变量Logistic回归分析发现,SDNN和 RMSSD减小是高血压患者合并焦虑抑郁的独立危险因素(P<0.05)；与对照组比较,试验组治疗前后 SAS评分、SDS评分、24 h平均血压、白昼平均血压和夜间平均血压、SDNN、SDANN和 RMSSD的差值明显增大(P<0.05)。结论与单纯高血压病患者比较,合并有焦虑和抑郁的高血压病患者有血压升高幅度大和心率变异性小的临床特点,心率变异性减低是导致焦虑和抑郁的危险因素,积极进行抗焦虑抑郁治疗可能更有利于降压效果和改善心率变异性异常。
목적：탐토고혈압병합병초필、억욱환자적림상특점급기여심솔변이성적관계。방법수집아원심혈관내과병방화문진수치적고혈압병환자200례,근거시부합병유초필화억욱,장소유환자분위초필억욱조화비초필억욱조,재근거시부항초필억욱치료,장초필억욱조환자분위시험조화대조조,대소유환자24 h동태혈압화심솔변이성진행분석。결과200례고혈압병환자중존재초필70례(35.0%),억욱65례(32.5%),초필억욱조적초필자평량표(SAS)평분급억욱자평량표(SDS)평분、24 h평균혈압、백주평균혈압화야간평균혈압명현고우비초필억욱조(P<0.05),이 NN간기표준차(SDNN)、NN간기평균치적표준차(SDANN)、상린 NN간기차치적균방근(RMSSD)명현저우비초필억욱조(P<0.05)。다변량Logistic회귀분석발현,SDNN화 RMSSD감소시고혈압환자합병초필억욱적독립위험인소(P<0.05)；여대조조비교,시험조치료전후 SAS평분、SDS평분、24 h평균혈압、백주평균혈압화야간평균혈압、SDNN、SDANN화 RMSSD적차치명현증대(P<0.05)。결론여단순고혈압병환자비교,합병유초필화억욱적고혈압병환자유혈압승고폭도대화심솔변이성소적림상특점,심솔변이성감저시도치초필화억욱적위험인소,적겁진행항초필억욱치료가능경유리우강압효과화개선심솔변이성이상。
Objective To determine the clinical characteristics of hypertensive patients with anxiety and depression,and the correlation between heart rate variability(HRV).Methods Two hundreds hypertensive patients with anxiety and depression were divided into two groups according to SAS and SDS scores,and then randomly divided into two subgroup according to whether treatment with anx-iety and depression.Ambulatory blood pressure and HRV were compared between two groups.Results 35% of patients was accom-panied with anxiety and 32.5% with depression in 200 hypertensive patients.The indexes for ambulatory blood pressure,SAS scores and SDS scores of anxiety and depression group were significantly higher than that in no anxiety and depression group(P<0.05). And the HAV index(SDNN,SDANN and RMSSD)of anxiety and depression group were significantly lower than that in no anxiety and depression group(P<0.05).The difference of SAS scores,SDS scores and ambulatory blood pressure before and after treat-ment were significantly increased(P<0.05).Conclusion Hypertensive patients with anxiety and depression,whose blood pressure are higher than other hypertensive patients,and the HRV are lower than others.Low HRVs are the risk factors of anxiety and depres-sion for hypertensive patients.Anti anxiety and depression treatment may be beneficial to the hypotensive effect and improve the HRV.